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1
Caribbean Civil Society
NCD ADVOCACY PLAN
Creating a Civil Society Movement for NCD Advocacy in the Caribbean
Healthy Caribbean Coalition
June 2014
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Table of Contents
1 Abbreviations ........................................................................................................................................ 3
2 Executive Summary............................................................................................................................... 4
3 Introduction .......................................................................................................................................... 5
4 Background ........................................................................................................................................... 6
5 Goal and Objectives .............................................................................................................................. 8
6 Action Plan ............................................................................................................................................ 9
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1 Abbreviations
ACS American Cancer Society
CSO Civil Society Organisation
CARPHA Caribbean Public Health Agency
HCC Healthy Caribbean Coalition
HPV Human Papillomavirus
NCD Non Communicable Disease
NCDA NCD Alliance
PAHO Pan American Health Organisation
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2 Executive Summary
The Regional NCD Civil Society Advocacy Plan is an initiative of the Healthy Caribbean Coalition (HCC) under the NCD Alliance/Medtronic Philanthropy Grant funded project “Strengthening Health Systems, Supporting NCD Action”. The grant supports this NCDA programme aimed at strengthening national and regional civil society NCD advocacy efforts in Brazil, South Africa and key Caribbean Community Countries (CARICOM) to raise demand and advocate to governments to strengthen health systems through an integrated approach to action on NCDs. The deliverables of the grant include: hosting a multi-‐stakeholder NCD meeting; production of a Civil Society NCD Regional Status Report, production and implementation of a Civil Society Advocacy Plan; and hosting of a health systems strengthening multi-‐stakeholder meeting.
The specific components of the plan are informed by the ‘Call to Action’ found in the NCDA/Medtronic Philanthropy funded NCD Regional Status Report (A Civil Society Regional Status Report: Responses to NCDs in the Caribbean Community) and aligned with the HCC Strategic Plan 2012 -‐2016 and reflect all four of the strategic areas of that plan: Advocacy; Enhancing Communication; Capacity Building; and Promoting mHealth and eHealth.
In 2012 the HCC established Official Relations with PAHO and in so doing committed inter alia to collaborate on issues related to advocacy, and share activities that addressed ‘Improved health and quality of life and communication and advocacy around NCDs’.
Supported by other grants, funding provided by the present grant will be used to implement a regional advocacy and education initiative aimed at increasing civil society capacity and building public awareness around priority policy and programming NCD needs in order to lay the foundation for greater civil society awareness and action aimed at lobbying for improved services. Further, high-‐level decision-‐makers and gatekeepers will be targeted to catalyse these individuals into greater action around policy development and reform to improve service delivery and ultimately reduce NCD related morbidity and mortality.
There are 2 Goals of this plan as listed below.
Goal I: To Strengthen the NCD prevention and control evidence-‐informed advocacy capacity of Caribbean Civil Society Organisations (CSOs).
Goal II: To Increase HCC regional evidence-‐informed advocacy.
The specific objectives of these goals can be found in section 5 of this document.
Where possible the HCC will identify regional and national partners as collaborators on this project in order to leverage the experiences and expertise of those working in this area and to increase regional buy-‐in and long-‐term sustainability of project outcomes and impact.
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3 Introduction
The Healthy Caribbean Coalition (HCC) was founded in October 2008 as a loose alliance and network for the purpose of combating non communicable diseases (NCDs). It arose out of 2007 Declaration of Heads of Government of CARICOM on NCDs. The HCC is a regional network of Caribbean health NGOs and civil society organizations with the remit to address NCDs, registered as a not-‐for-‐profit company. In December 2012 the HCC finalised the 2012-‐2016 Strategic Plan, with strategic areas of Advocacy; Enhancing Communication; Capacity Building; and Promoting mHealth and eHealth. These four strategic areas will inform it’s functioning over the next 3 years. The HCC works closely with regional and international leaders in NCD prevention to leverage the power of civil society by strengthening and supporting our membership in the implementation of programmes aimed and reducing the morbidity and mortality associated with NCDs.
Strengthening Health Systems, Supporting NCD Action is a NCD Alliance/ Medtronic Philanthropy funded global initiative. It aims to support and strengthen national and regional civil society NCD advocacy efforts in Brazil, South Africa and key Caribbean Community (CARICOM) to raise demand and advocate governments to strengthen health systems through an integrated approach to action on NCDs. The HCC is the National Implementing partner for CARICOM. The programme monitors national progress on NCDs and has identified gaps in national plans that must be addressed to ensure progress towards the implementation of globally agreed commitments and achievement of targets. One of the key outputs the project thus far has been a report: A Civil Society Regional Status Report: Responses to NCDs in the Caribbean Community. The purpose of the report was to understand and assess the Caribbean response to non-‐communicable diseases (NCDs), from a civil society perspective. It highlighted best practices and identified areas for further action. It provides an evidence-‐based platform, from which civil society can monitor progress as well as complement regional and national NCD policies and programmes. The HCC Advocacy Technical Working Group (TWG) has reviewed the report findings and developed an evidence-‐informed regional civil society NCD Advocacy Plan which takes into account priority areas for CSO led advocacy action; funding realities; timelines; and existing regional HCC and partner projects so as to avoid duplication and harmonise efforts.
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4 Background
NCDs are the predominant health problem in CARICOM countries and cause substantially more deaths and disability than infectious diseases. Not only are mortality rates high, but CARICOM countries have approximately double the rate of premature deaths compared to richer countries. Additionally, high rates of the biological risk factors exist, especially obesity, diabetes and hypertension driven in turn by behaviours arising out of environmental and social conditions.
The HCC/UWI 2014 A Civil Society Regional Status Report: Responses to NCDs in the Caribbean Community found that the NCD response, regionally and nationally, is overall satisfactory. The response has been led by regional public health institutions (PAHO/WHO, CARPHA), CARICOM Secretariat, National Governments and their Ministries of Health, with the support of the University of the West Indies, and in-‐country health non-‐governmental organisations and the recently formed civil society NCD Alliance, and the HCC. The response may be characterised as being strong on statements of support, agreements and policy positions but less so with respect to implementation, monitoring and evaluation. The Region has played a significant role globally in advancing the response to NCDs.
The report recommended that the following actions be taken by CARICOM countries at national level and collectively at the regional level:
• Banning (or at the very least limiting) the marketing of energy dense, high salt, foods and beverages to children.
• Promoting reduction in salt consumption and reduction in consumption of sugar sweetened beverages (including fruit juices).
• Banning of the use/sale of trans fats. • Establishment of regional standards for clear, consistent, food labelling. • Development of policies on physical activity; and development, implementation and monitoring
of national strategies on the promotion of physical activity. • Development of policies on reduction in harm from alcohol: development, implementation and
monitoring of national strategies on the reduction in harm from alcohol. • Use of up to date regionally derived evidence based guidelines for the treatment and
management of chronic diseases. • All residents within CARICOM countries/territories have access to basic defined packages of NCD
care irrespective of their ability to pay. • Development and implementation of a framework for standardising the treatment of
hypertension using available core medications. • Application of the chronic care model in the provision of primary health care services in
countries, with advocacy for all residents within CARICOM countries/territories to have access to basic defined packages of NCD care irrespective of their ability to pay.
• Build a truly ‘all of society approach’ addressing health in all policies. • NCDs to be fully addressed within national development plans. • Opportunities sought for multi-‐stakeholder approach to the response to NCDs by engaging
major groups of the society such as Faith-‐based organisations, groups of retired persons, women’s groups, and workers representatives.
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Meeting this, or a similarly ambitious, agenda for NCD action across the CARICOM countries and territories will require national capacity building, regional leadership and a multistakeholder response. From a civil society perspective, HCC is committed to continuing a regional leadership role, building the advocacy capacity among its member organisations and holding, together with other CSOs, policy makers to account as part of the traditional civil society “watch dog” role.
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5 Goal and Objectives
The Goal I of this plan is: To Strengthen the NCD prevention and control evidence-‐informed advocacy capacity of Caribbean Civil Society Organisations (CSOs).
The specific objectives of Goal I are:
SO1. To support CSO led advocacy to support the implementation of one key article of the FCTC in a CARICOM country with existing tobacco control legislation.
SO2. To support the development of a draft regional alcohol policy. SO3. To raise the profile of NCDs in the region through the development of a regional initiative
‘Faces of NCDs’ enlisting champions living with NCDs to be advocates for national action and accountability around NCD commitments.
SO4. To increase FBO commitment to collective NCD action in two CARICOM countries. SO5. To strengthen the capacity of CSOs to support health systems strengthening.
The Goal II of this plan is: To Increase HCC regional evidence-‐informed advocacy.
The specific objectives of Goal II are:
SO1. To lobby for HCC ‘Observer Status’ in regional decision making mechanism including CARICOM and CARPHA.
SO2. To strengthen high-‐level regional NCD advocacy through the identification and support of a network of high-‐level champions.
SO3. To develop a series of advocacy briefs addressing key NCD advocacy issues in the Caribbean.
SO4. To advocate for a regional and /or national mechanism for the recognition of e-‐advocacy. SO5. To support national NCD advocacy efforts at a regional level in particular as they relate to
the FCTC and multi-‐sectoral approaches to NCD prevention and control.
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6 Action Plan
The following table provides a summary of the action plan detailing activities which will be undertaken to achieve each of the specific objectives, the time needed for each activity, the responsible individuals, the budget in USD and budget notes.
The NCD Alliance is an active supporter and partner for all the different activities described in the advocacy plan.
Timeline: It is expected that the activities under this plan will be implemented over a 7-‐month period between June and December 2014.
The total budget is: $26,570.00 USD Goal I: $21,000.00 USD Goal II: $5,570.00 USD
GOAL I: To Strengthen the NCD prevention and control evidence-‐informed advocacy capacity of Caribbean Civil Society Organisations (CSOs).
Activities Timeline Responsible Person
Budget (USD)
Budget Notes
Planned Partners / Collaborators 1
SO1. To support CSO led advocacy to support the implementation of one key article of the FCTC in a CARICOM country with existing tobacco control legislation. SO1.1: Strengthen the Trinidad & Tobago Coalition for Tobacco Control.
July – November 2014
HCC Manager & Partners in TT
Total $7,000.00 for all activities under this objective.
• Trinidad & Tobago Cancer Society (TTCS)
• Trinidad & Tobago Coalition for Tobacco Control (TTCTC)
• TT MOH • Jamaica
Coalition for Tobacco Control (JCTC)
SO1.2: Hold planning meetings with key stakeholders including decision makers and policy makers.
September 2014
HCC Manager & Partners in TT
See above. *See above
SO1.3: Develop implementation plan in partnership with MOH.
August to October 2014
HCC Manager & Partners in TT
See above. *See above
SO1.4: Conduct dissemination meetings with key decision makers and policy makers.
October to November 2014
HCC Manager & Partners in TT
See above. In addition to partners identified above: The Caribbean Cancer
1 The NCD Alliance is an active supporter and partner for all the different activities described in the advocacy plan.
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Alliance (CCN) SO2. To support the development of a draft regional alcohol policy. SO2.1 Finalise regional situational analysis.
August – September 2014
HCC Consultant No cost – underway.
• University of the West Indies (TBC)
• Pan American Health Organisation (PAHO) -‐ PANNAPH
• Global Alcohol Policy Alliance (GAPA)
SO2.2 Develop draft policy in consultation with PAHO and national government. *Grenada TBD
September – October 2014
HCC Consultant $1,000.00 • University of the West Indies (TBC)
• Pan American Health Organisation (PAHO) -‐ PANNAPH
SO2.3 Hold meetings with regional stakeholders CARICOM/CARPHA/PAHO re adoption of the alcohol policy.
September – November 2014
HCC Manager and Consultant
$500.00 • University of the West Indies (TBC)
• Pan American Health Organisation (PAHO) -‐ PANNAPH
• Global Alcohol Policy Alliance (GAPA)
SO3. To raise the profile of NCDs in the region through the development of a regional initiative ‘Faces of NCDs’ enlisting champions living with NCDs to be advocates for national action and accountability around NCD commitments. SO3.1 Working with CARPHA and a national NCD Commission and a local CSO to develop a national media campaign which can be scaled up regionally. Pilot country Jamaica.
September to November 2014
HCC Manager and identified partners
Total $5,000.00
• Caribbean Public Health Agency (CARPHA)
• Heart Foundation of Jamaica
• Diabetes Association of Jamaica
• Medical Association of Jamaica
SO4. To increase FBO commitment to collective NCD action in two CARICOM countries. SO4.1 Support leading National NCD September HCC Manager Meeting • Dominica NCD
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Commissions in two CARICOM countries in the implementation of an FBO NCD Declaration building on the Barbados model (Feb 2014). Target countries: Dominica & St. Kitts
to October 2014
and NCD Commissions in 2 Territories
Costs Possibly $3,500.00 per country Total $7,000.00
Commission; St.Kitts NCD Commission
• FBOs in Dominica and St.Kitts
• PAHO SO5. To strengthen the capacity of CSOs to support health systems strengthening. SO6.1 Disseminate promotional materials re the Global Standardised Hypertension Treatment Project Barbados Pilot & CARPHA HT Guidelines -‐ Regionally as a mechanism for Health Systems Strengthening in support of regional scale up of this initiative. Target country: Jamaica
September – November 2014
HCC Manger, Heart Foundation of Jamaica
$500.00 • Heart Foundation of Jamaica
• Heart & Stroke Foundation of Jamaica
• PAHO • CDC
GOAL II: To Increase HCC regional evidence-‐informed advocacy.
Activities Estimated Duration
Responsible Person
Budget (USD)
Budget Notes
Partners
SO1. To lobby for HCC ‘Observer Status’ in regional decision making mechanism including CARICOM and CARPHA.
SO1.1: Send letters to CARICOM requesting Observer Status at CMO meetings and Heads of State Meetings.
July – November 2014
HCC Manager No Cost CARICOM
SO1.1.1: Attend CARICOM meetings as CSO Observer.
April 2014 TBD
HCC Manager *See Travel in SO5 below
CARICOM
SO1.2: Finalise MOU with CARPHA and Observer Status.
July – September 2014
HCC Manager No Cost CARPHA
SO1.2.1: Attend CARPHA meetings as CSO Observer.
TBD HCC Manager *See Travel in SO5 below.
CARPHA
SO2. To strengthen high-‐level regional NCD advocacy through the identification and support of a network of high-‐level champions. SO2.1 Develop a database of national NCD Champions in each CARICOM country disaggregated by NCD area of focus and value added.
July – September 2014
HCC Consultant
Consultant Fee: $250.00
TBD
SO2.2 Send letters to identified champions requesting their commitment
September 2014
HCC Manager No Cost TBD
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to be identified as HCC National NCD Champions. SO2.3 Hold a virtual meeting of CARICOM Regional NCD Champions.
October 2014
HCC $55.00 Webinar costs
TBD
SO2.4 Develop a database of regional youth NCD Champions/ Ambassadors/ Advocates active on social media.
July – September 2014
HCC MPH Intern
$200.00 TBD
SO2.5 Connect identified champions on an HCC platform brining together their voices and connecting them with young people across the Caribbean.
August – October 2014
HCC Intern TBD
SO3. To develop a series of NCD advocacy briefs addressing key NCD issues in the Caribbean. SO3.1 To develop and disseminate widely a report on the status of National NCD Commissions in CARICOM and make recommendations for the structure and roles of NNCDCs as key instruments/mechanisms of national coordinated multisectoral action on NCDs.
June – August 2014
HCC Consultant
Consultant Fee: $1,300.00
• University of the West Indies
• Regional NCD Commissions
• PAHO
SO3.2 Develop and disseminate widely a position paper/ brief on the marketing of unhealthy foods to young people in the Caribbean identifying key challenges, best practices and recommendations.
August – October 2014
HCC Consultant
Consultant Fee: $750.00
• University of the West Indies
• CARPHA • CARICOM • PAHO • Yale Rudder
Centre for Food Policy and Obesity (TBD)
• Obesity Policy Coalition (TBD)
SO3.3 Develop and disseminate widely a position paper/ brief on the impact of regional and national trade on the NCD response in the Caribbean identifying key challenges, best practices and recommendations.
August – October 2014
HCC Consultant
Consultant Fee: $750.00
• University of the West Indies
• CARPHA • CARICOM • PAHO • School of Public
Health and Human Biosciences, La Trobe University (TBD)
• Pacific Research Centre for the Prevention of Obesity and Non-‐Communicable Diseases (TBD)
• Menzies Centre
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for Health Policy, The University of Sydney (TBD)
SO4. To support national NCD advocacy efforts at a regional level in particular as they relate to FCTC and multi-‐sectoral approaches to NCD prevention and control. SO4.1 Document ongoing support of membership advocacy activities.
July – November 2014
HCC Manager No Cost HCC Membership
SO4.2 Make available, all advocacy tools, to HCC membership on our website including the NCDA Online Advocacy Toolkit.
July – November 2014
HCC Manager No Cost HCC Membership
SO5. Cross Cutting SO5.1 Consultation meetings July –
November 2014
HCC Manager Travel $2,265.00
HCC Membership and partner CSOs.